Provider Demographics
NPI:1598589517
Name:OWENS-GOODE, MICHELLE (LMSW 17706)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:OWENS-GOODE
Suffix:
Gender:F
Credentials:LMSW 17706
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 E REDWOOD ST FL 5
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-1115
Mailing Address - Country:US
Mailing Address - Phone:410-396-2209
Mailing Address - Fax:
Practice Address - Street 1:7 E REDWOOD
Practice Address - Street 2:5TH FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-1115
Practice Address - Country:US
Practice Address - Phone:410-396-2209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17706104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker